Clinical characteristic and risk factors for post-operative complications in women undergoing laparoscopy myomectomy

IF 2.1 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology Pub Date : 2025-03-31 DOI:10.1016/j.ejogrb.2025.113949

Reut Rotem , Neta Jacobowitz Bodner , Miri Erenberg , Yael Reicher , Zehava Yohay , Adi Y. Weintraub

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引用次数: 0

Abstract

Objective

To assess clinical characteristic and risk factors for post-operative complications in women undergoing laparoscopic myomectomy using the Clavien-Dindo classification system.

Methods

A retrospective cohort study was conducted at Soroka University Medical Center, Beer Sheva, Israel, between 2010 and 2020, including women who underwent laparoscopic myomectomy. Postoperative adverse events were classified using the Clavien-Dindo system. The study population was divided into two groups: those with complications (Clavien-Dindo classification ≥ 1) and those without complications (Clavien-Dindo classification = 0). Risk factors were compared between the groups and analyzed for statistical significance using univariate and multivariate logistic regression.

Results

A total of 111 women who underwent laparoscopic myomectomy were included. Of these, 26 experienced complications (study group) and 85 did not (comparison group); all complications were minor. Women in the study group had a higher incidence of pre-operative symptoms (76.9 % vs. 55.3 %). Additionally, the duration of surgery was significantly longer in the study group (137 min vs. 97 min, p < 0.01), and estimated blood loss was higher, with more frequent use of anti-adhesive agents. There was no significant difference in preoperative anemia between the groups. Estimated blood loss > 100 mL was found to be independently associated with complications (aOR 4.4, 95 % CI 1.5–12.5).

Conclusion

Laparoscopic myomectomy is a safe and effective surgical option for women, with a low rate of minor complications. Although longer surgeries and increased blood loss were associated with complications, the overall risk remains minimal. Proper identification of risk factors such as pre-operative symptoms and intraoperative blood loss can help optimize patient outcomes. Future research should further explore the relationship between anemia and surgical outcomes, as no significant differences in anemia were observed in this study.

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腹腔镜子宫肌瘤切除术妇女术后并发症的临床特点及危险因素

目的应用Clavien-Dindo分类系统评价腹腔镜子宫肌瘤切除术的临床特点及术后并发症的危险因素。方法回顾性队列研究于2010年至2020年在以色列比尔谢瓦的Soroka大学医学中心进行，包括行腹腔镜子宫肌瘤切除术的妇女。术后不良事件分类采用Clavien-Dindo系统。将研究人群分为有并发症组（Clavien-Dindo分类≥1）和无并发症组（Clavien-Dindo分类= 0），比较两组间的危险因素，采用单因素和多因素logistic回归分析有无统计学意义。结果共纳入111例行腹腔镜子宫肌瘤切除术的妇女。其中，26例出现并发症（研究组），85例未出现并发症（对照组）；所有并发症均轻微。研究组女性的术前症状发生率较高（76.9% vs. 55.3%）。此外，研究组的手术时间明显更长(137分钟vs 97分钟，p <；0.01)，估计失血量较高，抗粘剂的使用频率较高。两组患者术前贫血无显著性差异。估计失血量>；发现100 mL与并发症独立相关（aOR 4.4, 95% CI 1.5-12.5）。结论腹腔镜子宫肌瘤切除术是一种安全有效的手术方法，并发症发生率低。虽然手术时间延长和出血量增加与并发症有关，但总体风险仍然很小。正确识别术前症状和术中失血等危险因素有助于优化患者预后。未来的研究应进一步探讨贫血与手术结果的关系，因为本研究中未观察到贫血的显著差异。

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来源期刊

European journal of obstetrics, gynecology, and reproductive biology 医学-妇产科学

CiteScore

4.60

自引率

3.80%

发文量

898

审稿时长

8.3 weeks

期刊介绍： The European Journal of Obstetrics & Gynecology and Reproductive Biology is the leading general clinical journal covering the continent. It publishes peer reviewed original research articles, as well as a wide range of news, book reviews, biographical, historical and educational articles and a lively correspondence section. Fields covered include obstetrics, prenatal diagnosis, maternal-fetal medicine, perinatology, general gynecology, gynecologic oncology, uro-gynecology, reproductive medicine, infertility, reproductive endocrinology, sexual medicine and reproductive ethics. The European Journal of Obstetrics & Gynecology and Reproductive Biology provides a forum for scientific and clinical professional communication in obstetrics and gynecology throughout Europe and the world.